Transient engraftment of syngeneic bone marrow after conditioning with high-dose cyclophosphamide and thoracoabdominal irradiation in a patient with aplastic anemia.
We describe the clinical course of a 16 year old girl with aplastic anemia who was treated by syngeneic bone marrow transplantation. Engraftment was not obtained by simple infusion of bone marrow without immunosuppression. The patient received a high-dose cyclophosphamide and thoracoabdominal irradiation, followed by second marrow transplantation from the same donor. Incomplete but significant hematologic recovery was observed; however, marrow failure recurred 5 months after transplantation. Since donor and recipient pairs were genotypically identical, graft failure could not be attributed to immunological reactivity of recipient cells to donor non-HLA antigens. This case report implies that graft failure in some cases of aplastic anemia might be mediated by inhibitory cells resistant to cyclophosphamide and irradiation.
Matsue
K
K
Blood Transfusion Division, Kanazawa University Hospital, Japan.
Niki
T
T
Shiobara
S
S
Ueda
M
M
Ohtake
S
S
Mori
T
T
Matsuda
T
T
Harada
M
M
D000005:Abdomen / Q000528:radiation effects; D000293:Adolescent; D000741:Anemia, Aplastic / Q000532:radiotherapy / Q000601:surgery*; D001853:Bone Marrow / Q000473:pathology; D016026:Bone Marrow Transplantation; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006801:Humans; D013909:Thorax / Q000528:radiation effects; D013997:Time Factors
D003520:Cyclophosphamide